Chapter 49: Drugs for Eye and Ear Disorders Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 49: Drugs for Eye and Ear Disorders

Test Bank

MULTIPLE CHOICE

1. A client has increased intraocular pressure, and pilocarpine (Isopto Carpine, Pilopine HS, others) has been ordered. The nurse needs to review the medical history because this drug would be contraindicated for the client with:

a.

asthma.

b.

cardiovascular disease.

c.

kidney disease.

d.

ulcer disease.

ANS: A

This medication, while dilating the pupils, may constrict the airway.

DIF: Cognitive Level: Application REF: pp. 734-735

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. As part of client teaching about miotics, the nurse describes the symptoms indicative of drug toxicity. The highest priority nursing intervention when systemic toxicity is suspected after the client has been treated with a miotic medication is to administer.

a.

cascara.

b.

calcium gluconate.

c.

demecarium bromide.

d.

atropine sulfate.

ANS: D

Atropine is the antidote to the parasympathetic stimulation of the miotics.

DIF: Cognitive Level: Application REF: pp. 735, 738

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A client is using the ocular therapeutic system. She tells the nurse that she typically changes the Ocusert every 10 days to save money. What is the most accurate response from the nurse?

a.

This practice will allow you to achieve a more therapeutic response from your medication.

b.

This practice is not recommended, but is allowable under the circumstances.

c.

This practice is not acceptable because the Ocusert should be applied at bedtime nightly.

d.

This practice is not acceptable because the Ocusert should be changed every 7 days.

ANS: D

The Ocusert disc should be changed every 7 days once it is applied; the gel form of the drug is applied nightly.

DIF: Cognitive Level: Application REF: p. 736

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse is completing a health history on a client who is scheduled to be treated with cyclopentolate (Cyclogyl). Which finding would cause the nurse to contact the physician?

a.

Parkinsonism

b.

Pregnancy

c.

Asthma

d.

Glaucoma

ANS: D

The cycloplegic agents paralyze the ocular muscles and may cause an increase in intraocular pressure (IOP). Thus, the medication would be contraindicated for a client experiencing glaucoma.

DIF: Cognitive Level: Application REF: p. 734

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. What would be an indication of a positive outcome for the client who is receiving treatment with a topical anesthetic for a disorder of the eye?

a.

Absence of the blink reflex

b.

Moist corneal epithelium

c.

No need for a patch over the eye

d.

Presence of corneal anesthesia for at least 4 hours

ANS: A

An absence of the blink reflex indicates effectiveness of the topical anesthetic.

DIF: Cognitive Level: Application REF: p. 731

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A client who is 10 years old has an infection of the external ear and is being treated with polymyxin B and hydrocortisone. The nurse anticipates that the client will need an additional medication to relieve:

a.

edema.

b.

itching.

c.

redness.

d.

pain.

ANS: D

An antiinflammatory will decrease edema, itching, and redness, but it is not an analgesic.

DIF: Cognitive Level: Application REF: p. 742

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. A 9-month-old client enters the emergency department carried by his parent. The parent states, He is fussy and wont eat. He feels hot and is pulling at his ears. Acute otitis media (OM) is diagnosed. What is the first-line drug for treatment of middle ear infection?

a.

Acetyl sulfisoxazole (Gantrisin)

b.

Amoxicillin (Amoxil, Augmentin)

c.

Erythromycin (E-Mycin)

d.

Cefaclor (Ceclor)

ANS: B

Amoxicillin (Amoxil, Augmentin) is the drug of choice for acute otitis media.

DIF: Cognitive Level: Comprehension REF: p. 742

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. Which nursing intervention would be the highest priority to prevent systemic absorption of eye drops?

a.

Apply the drops in the outer canthus of the eye.

b.

Have the patient perform the Valsalva maneuver during administration.

c.

Have the patient close the eyes for 2 minutes after instillation.

d.

Apply pressure to the lacrimal duct after administration.

ANS: D

The application of pressure to the lacrimal duct after administration of eye drops will prevent systemic absorption of the drops.

DIF: Cognitive Level: Application REF: p. 734

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A client is to be treated with a carbonic anhydrase inhibitor as a means to decrease intraocular pressure. What priority instruction should be included in the nurses teaching plan?

a.

Allow 5 to 10 minutes after instillation before using another medication.

b.

Provide strict fluid restrictions at all times.

c.

Provide environmental safety and seizure precautions.

d.

Encourage the client to sit in sunlight to enhance metabolism of the drug.

ANS: A

To promote maximum absorption, the client should allow 5 to 10 minutes after the drops are instilled before applying another medication.

DIF: Cognitive Level: Application REF: pp. 738-739

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client is an African American who has been diagnosed with glaucoma. The nurse anticipates that which medication will be most effective for this client?

a.

Latanoprost (Xalatan)

b.

Bimatoprost (Lumigan)

c.

Travoprost (Travatan)

d.

Unoprostone (Rescula)

ANS: C

Travoprost has been found to be more effective in African Americans than in non-African Americans.

DIF: Cognitive Level: Application REF: p. 737

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The client is scheduled for ophthalmic surgery. She tells the nurse that she typically self-medicates with herbs for various ailments in the home setting. What is the most accurate response from the nurse?

a.

Herbal therapy may actually intensify any discomfort from the surgery.

b.

Any herbal therapy must be discontinued before the client undergoes surgery.

c.

Herbal therapy may lead to a better surgical outcome for the client.

d.

Any herbal therapy that has been started before surgery should be continued.

ANS: B

Because many herbs alter coagulation, they generally are discontinued before ophthalmic or otic surgery.

DIF: Cognitive Level: Application REF: p. 734

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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